Thursday, July 7, 2011

Stroke Risk in Pregnant Women 2.4 Times Higher, Loyola Researchers Report

MAYWOOD, Ill. -- High blood pressure during pregnancy is a leading cause of maternal and fetal mortality worldwide. Pregnant women face a risk of stroke that is 2.4 times higher than the risk in nonpregnant women, according to a medical journal article by Loyola University Health System researchers. The review article on pregnancy-induced high-blood-pressure syndromes is published in the journal Women's Health. "Prompt diagnosis and identification of patients at risk allows for early therapeutic interventions and improved clinical outcomes," the Loyola authors wrote. Pregnancy-induced high-blood-pressure syndromes include pre-eclampsia, eclampsia and a rare but serious illness called HELLP (hemolysis, elevated liver enzymes and low platelet count). Pre-eclampsia is a multisystem disorder characterized by high blood pressure (top or bottom numbers equal to or greater than 140/90, when measured on two occasions six hours apart) and proteinuria (excess protein in urine -- more than 300 mg. in 24 hours). Left untreated, pre-eclampsia can cause serious complications, possibly fatal, in the mother and baby. In severe pre-eclampsia, patients may develop oliguria (reduced urine output), pulmonary edema (fluid in the lungs), liver dysfunction, thrombocytopenia (low platelet count) and changes in mental status and other cerebral symptoms. Patients may have headaches, stupor, visual blurring, blindness (often temporary) or seizures. Pre-eclampsia can progress to eclampsia or HELLP. Pre-eclampsia develops into eclampsia when a patient experiences convulsive seizures or goes into a coma. HELLP can cause bleeding, liver problems and high-blood-pressure problems, harming both mother and baby. "Pre-eclampsia/eclampsia-related events are a major cause of maternal disability and maternal and fetal death in the USA, and without prompt and aggressive treatment these patients may rapidly decline," the Loyola authors wrote. All four are neurologists in the Loyola Stroke Program. For pregnant women who have pre-eclampsia risk factors, starting aspirin at 12 to 14 weeks may decrease the risk of pre-eclampsia and death of the baby. Once a patient is diagnosed with pre-eclampsia/eclampsia, physicians attempt to control blood pressure and seizures and manage brain swelling. "Prompt delivery of a viable baby remains the main and only curative therapeutic intervention," the authors wrote. Women who have pre-eclampsia are at higher risk for future stroke and cardiovascular disease. The researchers wrote that identifying patients at risk of pregnancy-induced high-blood-pressure syndrome remains "a major research focus." The authors are in the Department of Neurology of Loyola University Chicago Stritch School of Medicine. They are Sarkis Morales-Vidal, MD (first author); Michael Schneck, MD; Murray Flaster, MD; and senior author José Biller, MD. Morales is an assistant professor, Flaster is an associate professor, Schneck is a professor and Biller is a professor and department chairman.

About Loyola University Health System

Loyola University Health System (LUHS) is part of Trinity Health. Based in the western suburbs of Chicago, LUHS is a quaternary care system with a 61-acre main medical center campus, the 36-acre Gottlieb Memorial Hospital campus and more than 30 primary and specialty care facilities in Cook, Will and DuPage counties. Loyola University Medical Center’s campus is conveniently located in Maywood, 13 miles west of Chicago’s Loop and 8 miles east of Oak Brook, Ill. At the heart of the medical center campus is a 559-licensed-bed hospital that houses a Level 1 Trauma Center, a Burn Center and the Ronald McDonald® Children's Hospital of Loyola University Medical Center. Also on campus are the Cardinal Bernardin Cancer Center, Loyola Outpatient Center, Center for Heart & Vascular Medicine and Loyola Oral Health Center as well as Loyola University Chicago Stritch School of Medicine, Loyola University Chicago Marcella Niehoff School of Nursing and the Loyola Center for Fitness. Loyola's Gottlieb campus in Melrose Park includes the 255-licensed-bed community hospital, the Professional Office Building housing 150 private practice clinics, the Adult Day Care, the Gottlieb Center for Fitness, Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park.

Trinity Health is a national Catholic health system with an enduring legacy and a steadfast mission to be a transforming and healing presence within the communities we serve. Trinity is committed to being a people-centered health care system that enables better health, better care and lower costs. Trinity Health has 88 hospitals and hundreds of continuing care facilities, home care agencies and outpatient centers in 21 states and 119,000 employees.